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Biomedical subjects

S M Weinstein

Publications and source records attributed to S M Weinstein.

At least 37 records · Page 2Linked to original sources
PubMed1995

Contemporary concepts in spine care. Epidural steroid injections.

Epidural steroid injections are commonly used for the management of lumbosacral radicular syndromes. The literature is replete with case reports and noncontrolled studies, but relatively few controlled studies exist. The well-designed studies that are available, however, do show a significantly positive pain reducing benefit from lumbar epidural steroid injections. This Contemporary Concepts review summarizes theoretic concepts, clinical applications, and data from the literature regarding the use of lumbar epidural steroid injections and provides current recommendations and suggestions for future research.

Adrenal Cortex Hormones↗
PubMed1995

Medical decision-making in a patient with a history of cancer and chronic non-malignant pain.

The selection of cancer pain treatment modalities depends on careful assessment to establish the pathophysiology of the pain complaint. Treatment may consist of a single modality--e.g., pharmacotherapy--or multiple modalities--e.g., pharmacotherapy, anesthetic intervention, and radiotherapy for bone pain. Cancer patients may present with pain and multiple concomitant medical problems related to their primary neoplastic disease, complications of cancer treatment, or unrelated conditions including preexisting pain of nonmalignant origin. We present the case of a patient with new onset of pain superimposed on chronic nonmalignant pain. This case emphasizes the need for careful assessment and the close cooperation required between the pain consultant and the referring oncology staff to make optimal treatment decisions in the context of a complex medical illness.

Carcinoma↗
PubMed1994

Phantom pain.

The natural course of postamputation phenomena in cancer patients, including phantom pain, is poorly understood. Phantom pain may be disabling in a significant minority of patients undergoing amputation for malignancy. Due to advances in pain research, the pathophysiology of phantom pain is better understood. Both peripheral and central nervous system mechanisms play a role. Therapeutic options for persistent phantom pain are currently limited. Research into pharmacologic prevention strategies may yield more effective methods. A multidisciplinary care approach is designed to facilitate physical and psychological recovery after loss of a body part. Medical decision trees pertaining to cancer amputation are presented. Oncologists should be familiar with what is known about phantom pain in order to counsel patients and make appropriate referrals for comprehensive care.

Humans↗
PubMed1992

Industrial rehabilitation medicine. 1. An overview.

This self-directed learning module provides a framework for the general concepts in industrial rehabilitation medicine. It is the first of four articles on this topic for the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This section includes material related to the work environment and the physician-patient relationship. In addition, material on the Americans with Disabilities Act informs the reader about the new consciousness employers will need to develop toward disabled workers.

Cumulative Trauma Disorders↗
PubMed1992

Industrial rehabilitation medicine. 2. Assessment of the problem, pathology, and risk factors for disability.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article covers ergonomic assessment of upper limb and low back injury, medical diagnostics for upper extremity cumulative trauma disorder (UE-CTD) and low back pain, and an evaluation of delayed recovery following work injury. Advances that are covered in this article involve factors contributing to UE-CTD, lumbar spine-imaging techniques, and the high-risk variables that contribute to prolonged disability.

Back Pain↗
PubMed1992

Industrial rehabilitation medicine. 3. Treatment.

This self-directed learning module highlights the important aspects of the physiatric approach to treatment of the injured worker. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses treatment of the worker who has sustained acute or chronic industrial injury.

Acute Disease↗
PubMed1992

Nerve problems and compartment syndromes in the hand, wrist, and forearm.

Most sports-related peripheral neuropathies occurring from the elbow distally are compressive in nature. These result from overuse or overload principles superimposed on normal or variant anatomy. Tensile injury occurs less often and is usually associated with the extremes of the throwing motion, i.e., cocking and follow-through phases of throwing. Neurogenic syndromes are usually incomplete, indicating the absence of severe motor or sensory deficits, but typically with subjective complaints of pain or vague sensory disturbance. As a result, nerve injuries are frequently overlooked as a source of acute or, more usually, chronic symptomatology. Further, distal symptoms are not always representative of distal pathology as evidenced by the double-crush phenomenon. Therefore, a strong neurologic and musculoskeletal evaluation is necessary in diagnosing sports-induced peripheral nerve trauma. When positive, electrodiagnostic testing can assist with localization and extent of injury, although absence of NCV or EMG abnormalities is not unusual. Accurate diagnoses are essential for planning specific treatment.

Arm Injuries↗
PubMed1991

Cerebral stroke in a semi-pro football player: a case report.

Cervical spine trauma can clearly result in neurologic injury. An unusual traumatic event is a vascular insult of the vertebral arteries, potentially leading to stroke. The vertebral arteries are vulnerable to compression at several sites in the cervical spine. The high degree of physiologic rotation at the atlanto-axial joint places the vertebral artery at risk through normal daily activities as well as following forceful trauma, including manipulative treatment. Cerebrovascular insufficiency is an uncommon but serious complication of cervical spinal manipulation, which can lead to posterior circulatory impairment. Comprehensive diagnostic studies may be required to differentiate primary intracranial pathology from cerebral symptoms secondary to vascular compromise.

Adult↗
PubMed1982

The I.V. nurse.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

A coordinated approach to home infusion care.

Home intensive care can now be delivered in the patient's home. The growth of this clinical setting has been attributed to aging, an increase in technology, and national reimbursement patterns. Institutional nurses must anticipate and meet the patient's need for education and training specific to the therapeutic treatment to be provided at home, especially in the case of the acutely ill patient requiring home infusion therapy. Thus our technologically advanced system demands a coordinated approach.

Community Health Nursing↗
PubMedDate not supplied

Integrating palliative care in oncology.

BACKGROUND: Cancer is the second leading cause of death among Americans. The World Health Organization has mandated an integrated approach to palliative care in the treatment of patients with cancer. However, medical decision making in the setting of life-threatening disease remains complicated. METHODS: An integrated palliative care approach depends on the skillful blend of antineoplastic, supportive, and palliative interventions. For standardizing care plans, documenting palliative interventions, and tracking and improving outcomes, palliative care elements are defined. At our institute, medical symptom management, psychosocial support, and advance care planning are incorporated into routine cancer care. RESULTS: Although progress is being made toward integrating palliative care in the field of oncology, further efforts are needed to ensure that cancer patients and their families who need palliative care receive it. CONCLUSIONS: If fully implemented, the integrated palliative care approach will result in quaternary prevention, ie, the prevention of suffering.

Humans↗
PubMedDate not supplied

Certification and credentialing to define competency-based practice.

One of the challenges that healthcare organizations face today is how to effectively establish, document, and evaluate competency in intravenous practice. The process used to define practice parameters based on national certification and credentialing versus organizational policies is described. Key attributes, the role of mentoring, and adverse outcomes are addressed.

Certification↗
PubMedDate not supplied

AIDS--pharmacologic update.

No one discounts the cruel nature of the Acquired Immunodeficiency Syndrome epidemic or the pain and devastation left by the virus that brings a lingering death to people in the prime of life. And no one dismisses the horrifying surge in the number of cases over the past decade. In 1981, 189 cases of AIDS were reported to the Centers for Disease Control; in 1990, 43,339 cases were reported. Research and technological advances have resulted in advanced treatment modalities aimed at symptomatic treatment of the disease process itself, opportunistic infections associated with the disease, and possibly prevention. These issues are addressed in this update.

Acquired Immunodeficiency Syndrome↗